Hidden Burden of on the African Continent: Should the Bacterial Infection Be Considered a Neglected Tropical Disease?

is a louse-borne gram-negative bacillus that remains a poorly characterized cause of bacteremia, fever, and infective endocarditis. Due to the link with pediculosis, transmission is tied to poverty, conflict, overcrowding, and inadequate water access to maintain personal hygiene. Although these risk factors may be present globally, we argue that a substantial burden of undocumented infection occurs in Africa due to the high prevalence of these risk factors. Here, we describe the neglected burden of infection, endocarditis, and vector positivity in Africa and evaluate whether meets criteria to be considered a neglected tropical disease according to the World Health Organization.